Escitalopram Cardiac Risk: What You Need to Know About Heart Safety and SSRIs

When you take escitalopram, a selective serotonin reuptake inhibitor (SSRI) used to treat depression and anxiety. Also known as Lexapro, it helps balance brain chemicals—but it can also affect your heart in ways most people don’t expect. While it’s generally safe, studies show that escitalopram, like some other SSRIs, carries a small but real risk of prolonging the QT interval on an ECG. This is a measure of how long it takes your heart to recharge between beats. If it gets too long, it can trigger a dangerous irregular heartbeat called torsades de pointes—even in people with no prior heart problems.

This risk isn’t the same for everyone. People over 65, those with existing heart conditions, or those taking other meds that also affect QT intervals (like certain antibiotics, antifungals, or antiarrhythmics) are more vulnerable. Even something as simple as low potassium or low magnesium from poor diet or diuretics can make the risk worse. The FDA and multiple clinical reviews have flagged this connection, especially when escitalopram doses go above 20 mg per day. That’s why doctors often start low and go slow, and why they may check your ECG before and after starting treatment if you’re at higher risk.

It’s not just about the drug itself—it’s about what else you’re taking and how your body handles it. For example, if you’re on propranolol, a beta blocker used for high blood pressure and anxiety, or digoxin, a heart medication that affects heart rhythm, your doctor needs to know. These drugs don’t always cause problems on their own, but together with escitalopram, they can push your heart into unstable territory. That’s why keeping a symptom diary, a detailed log of side effects, timing, and dosage can be life-saving. If you notice new dizziness, palpitations, or fainting spells, writing them down helps your doctor spot patterns fast.

Most people take escitalopram without any heart issues at all. But for those who do face this risk, awareness and monitoring make all the difference. You don’t need to stop the medication—you just need to understand the signs, know your other meds, and work with your doctor to stay safe. Below, you’ll find real posts from people who’ve dealt with this issue, from how to track side effects to what alternatives exist when heart safety becomes a concern. This isn’t theoretical—it’s practical, tested, and focused on what actually matters to your health.